Paging Dr. Frischer: Shrinking

Many times every day, I walk down the hall of my office as my nurse is measuring a patient’s height. I often hear the same reaction: “I didn’t used to be that short!”

We do shrink as we age, usually starting around the age of 40. Overall, men will lose about two inches by age 80, and women three inches. This happens because the bones of our spine lose density, and the gel-like disks that separate each vertebra get worn down and thin. As a result, our spinal column actually becomes shorter. This spine deterioration, compounded by muscle loss, can also cause that hunched-over look (cervical kyphosis).

As a woman approaches menopause, rapidly decreasing levels of estrogen can cause loss of bone mass, and after menopause, bone loss actually outpaces the building of new bone. This loss of bone density and associated loss of height is caused by osteoporosis. Women over 70 who lose height rapidly have a greater chance of fracturing a hip as well.

Shrinking is not inevitable, and happens differently for everyone. Those who live in the city shrink less than those who live in the country.Educated people shrink less than those who are uneducated. It’s likely that these types of differences are connected to accompanying habits such as drinking, smoking and inactivity.

What can we do to slow this height loss?

■ Women over 50 should supplement their daily diet with 1,000 mg of calcium, as well as at least 600 units of vitamin D, as this helps the body to absorb the calcium. The best food sources of calcium are almonds, broccoli, kale, salmon, and soy products like tofu. Dietary sources of vitamin D include oily fish, egg yolks, and fortified milk.

■  Exercise is critical. What we do *after* the age of 40 appears to have the biggest impact. Those who have always exercised, or even those who start exercising just after turning 40, lose only about half as much height as those who never exercise, or stop working out during middle age. The best exercise is weight bearing, like running, jumping, or strength training. Whatever puts stress on your bones will signal the body to add new cells and strengthen the bones.

■ Quit smoking. Smoking works in several different ways to cause bone loss, including by lowering estrogen levels.

■ More than one alcoholic drink per day also works in several ways to cause bone loss, including by blocking the absorption of calcium in the stomach.

Osteoporosis, resulting in loss of height and sometimes bone fractures, used to be considered a normal part of aging. We now understand it to be preventable and treatable. Proven strategies include consuming adequate amounts of calcium and vitamin D, participating in weight-bearing exercise, avoiding tobacco, limiting alcohol, and using medication when appropriate.

Talk to your doctor about an appropriate strategy for you.